Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LN0000X | Nurse Practitioner - Neonatal | 752517 | TX |
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | HAG1-0433-4054 | TX |
NPI | 1225223001 |
---|---|
Provider Name | Mr. David Marshall Haggard II |
First Address | Pearland, TX 77584-2295 |
Second Address | Fort Worth, TX 76104-2158 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2007 |
Last Update Date | 05/04/2011 |